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Related Experiment Videos

Upper cervical involvement in rheumatoid arthritis.

Y Morizono1, T Sakou, H Kawaida

  • 1Department of Orthopaedic Surgery, Faculty of Medicine, Kagoshima University, Japan.

Spine
|October 1, 1987
PubMed
Summary

Rheumatoid arthritis patients often develop atlanto-axial dislocation and odontoid migration. The Redlund-Johnell method is a useful indicator for diagnosing upward odontoid migration, suggesting severe conditions.

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Radiology

Background:

  • Rheumatoid arthritis (RA) frequently affects the cervical spine, particularly the atlanto-axial joint.
  • Atlanto-axial dislocation and upward migration of the odontoid are significant complications in RA patients.
  • Conservative management and surgical fusion are treatment options for these conditions.

Purpose of the Study:

  • To evaluate the prevalence of atlanto-axial dislocation and upward odontoid migration in RA patients.
  • To compare the diagnostic utility of Ranawat's and Redlund-Johnell methods for assessing odontoid migration.
  • To identify indicators for severe RA-related cervical spine involvement.

Main Methods:

  • Retrospective study of 100 RA patients treated conservatively.

Related Experiment Videos

  • Assessment of atlanto-axial dislocation and upward odontoid migration using Ranawat's and Redlund-Johnell methods.
  • Determination of normal values in healthy Japanese adults for comparison.

    • Main Results:

    • Atlanto-axial dislocation found in 49% and upward odontoid migration in 26% (Ranawat) or 8% (Redlund-Johnell) of conservatively treated patients.
    • Lesion detection increased with disease duration and RA progression.
    • Abnormal Redlund-Johnell values indicated severe conditions and upward odontoid migration.

    Conclusions:

    • The Redlund-Johnell method is a valuable indicator for diagnosing upward odontoid migration in RA.
    • Cervical spine lesions in RA primarily affect C1-C2 but can involve atlanto-occipital joints.
    • Surgical fixation for severe cases should include the occipital bone.